Over five million Americans live with extreme obesity (BMI e 40). Bariatric surgery is currently the most effective long-term treatment for extreme obesity; however, research regarding the relationship between bariatric outcomes and psychosocial factors such as social support is mixed and inconclusive. The proposed fellowship will prospectively and systematically assess the role of social support in weight loss, adherence to diet and lifestyle changes, and health behavior outcomes following bariatric surgery in a predominantly African American and low income patient population (N=55), groups disproportionately impacted by obesity and related conditions. Outcome measures at pre-operative baseline and 6-months post-operatively include weight, as well as self-report assessments of physical activity, eating behaviors, adherence and food intake frequency. Hypotheses posit that 1) greater increases in health-related social support will be associated with greater weight loss 6-months post-operatively; 2) greater increases in general social support will be associated with greater weight loss 6-months post-operatively; 3) greater increases in health-related social support will be associated with greater improvements in health behaviors and adherence 6-months post- operatively; and 4) greater increases in general social support will be associated with greater health behavior changes and adherence 6-months post-operatively. Secondary analyses will evaluate the relationship between specific aspects of health-related social support (i.e., diet and exercise) and general social support (i.e., structura or functional) and post-operative outcomes. Evaluating the role of social support in bariatric surgery provides an opportunity to identify novel targets for obesity interventions to help improve the treatment of bariatric surgery patients. PUBLIC HEALTH RELEVANCE: The proposed research has the potential to provide novel targets for obesity interventions. Further, findings of the proposed study may be applied to improve treatment of bariatric surgery patients.